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1.
Medicina (Kaunas) ; 57(1)2021 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-33435420

RESUMO

Background and Objectives: Vesicoureteral reflux (VUR) describes a common pediatric anomaly in pediatric urology with a prevalence of 1-2%. In diagnostics, in addition to the gold standard of voiding cystourethrography (VCUG), contrast-enhanced urosonography (ceVUS) offers a radiation-free procedure, which, despite its advantages, is not yet widely used. In the present single-center study, subsequent therapeutic procedures and outcomes after ceVUS of 49 patients were investigated. The aim of the study is to investigate the efficacy of ceVUS with the intention of broader clinical implementation. Materials and Methods: Between 2016 and 2020, 49 patients were retrospectively included and received a ceVUS to evaluate VUR. With a distribution of 47:2 (95.9%), a clear female predominance was present. The age of the patients varied between 5 months and 60 years at the time of ceVUS. All examinations were all performed and subsequently interpreted by a single experienced radiologist (EFSUMB level 3). Results: Compared to intraoperative findings, ceVUS shows a sensitivity of 95.7% with a specificity of 100%. Allergic reactions to the contrast medium could not be observed. Conclusion: With its high sensitivity and intraoperative validation, ceVUS offers an excellent alternative to VCUG, the gold standard in the diagnosis of VUR. In addition, ceVUS is a radiation-free examination method with a low risk profile that offers an exceptional diagnostic tool in the diagnostic clarification of recurrent urinary tract infections with the suspected diagnosis of VUR and should also be included in the consideration of a diagnosis next to the established VCUG, especially in younger children.


Assuntos
Meios de Contraste , Técnicas de Diagnóstico Urológico , Ultrassonografia/métodos , Refluxo Vesicoureteral/diagnóstico por imagem , Adolescente , Adulto , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Cistografia , Feminino , Humanos , Lactente , Injeções , Laparoscopia , Masculino , Pessoa de Meia-Idade , Fosfolipídeos , Politetrafluoretileno , Exposição à Radiação , Recidiva , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Hexafluoreto de Enxofre , Ureteroscopia , Uretra/diagnóstico por imagem , Bexiga Urinária/diagnóstico por imagem , Infecções Urinárias/etiologia , Infecções Urinárias/prevenção & controle , Urografia , Refluxo Vesicoureteral/classificação , Refluxo Vesicoureteral/complicações , Refluxo Vesicoureteral/terapia , Adulto Jovem
2.
Chemosphere ; 263: 127908, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32835973

RESUMO

The effects of breccia pipe uranium mining in the Grand Canyon watershed (Arizona) on ecological and cultural resources are largely unknown. We characterized the exposure of biota to uranium and co-occurring ore body elements during active ore production and at a site where ore production had recently concluded. Our results indicate that biota have taken up uranium and other elements (e.g., arsenic, cadmium, copper, molybdenum, uranium) from exposure to ore and surficial contamination, like blowing dust. Results indicate the potential for prolonged exposure to elements and radionuclides upon conclusion of active ore production. Mean radium-226 in deer mice was up to 4 times greater than uranium-234 and uranium-238 in those same samples; this may indicate a potential for, but does not necessarily imply, radium-226 toxicity. Soil screening benchmarks for uranium and molybdenum and other toxicity thresholds for arsenic, copper, selenium, uranium (e.g., growth effects) were exceeded in vegetation, invertebrates, and rodents (Peromyscus spp., Thomomys bottae, Tamias dorsalis, Dipodomys deserti). However, the prevalence and severity of microscopic lesions in rodent tissues (as direct evidence of biological effects of uptake and exposure) could not be definitively linked to mining. Our data indicate that land managers might consider factors like species, seasonal changes in environmental concentrations, and bioavailability, when determining mine permitting and remediation in the Grand Canyon watershed. Ultimately, our results will be useful for site-specific ecological risk analysis and can support future decisions regarding the mineral extraction withdrawal in the Grand Canyon watershed and elsewhere.


Assuntos
Exposição à Radiação , Poluentes Radioativos da Água/toxicidade , Animais , Arsênico/análise , Cádmio/análise , Cobre/análise , Invertebrados , Camundongos , Mineração , Monitoramento de Radiação , Radioisótopos/análise , Rádio (Elemento) , Roedores , Selênio/análise , Solo , Urânio/análise
3.
Br J Radiol ; 94(1117): 20190878, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33090887

RESUMO

OBJECTIVE: Mini C-arm fluoroscopes are widely used by orthopaedic surgeons for intraoperative image guidance without the need for radiographers. This puts the responsibility for radiation exposure firmly with the operating surgeon. In order to maintain safe and best practice under U.K. Ionising Radiation (Medical Exposure) Regulations, one must limit radiation exposure and audit performance using national diagnostic reference levels (DRLs). In the case of the mini C-arm, there are no national DRLs. IR(ME)R, therefore, require the establishment of local DRLs by each hospital to act as an alternative guideline for safe radiation use. The aim of our audit was to establish local DRLs based on our experience operating with the use of the mini C-arm over the last 7 years. METHODS: This retrospective audit evaluates the end dose-area product (DAP) recorded for common trauma and orthopaedic procedures using the mini C-arm in a busy district general hospital.We present the quartile data and have set the cut-off point as the third quartile for formulating the local DRLs, consistent with the methodology for the conventional fluoroscope. RESULTS: For our data set (n = 1664), the third quartile DAP values were lowest for surgeries to the forearm (5.38 cGycm2), hand (7.62 cGycm2), and foot/ankle (8.56 cGycm2), and highest for wrist (10.64 cGycm2) and elbow (14.61 cGycm2) procedures. ADVANCES IN KNOWLEDGE: To our knowledge, this is the largest data set used to establish local DRLs. Other centres may find our guidelines useful whilst they establish their own local DRLs.


Assuntos
Procedimentos Ortopédicos , Doses de Radiação , Exposição à Radiação/estatística & dados numéricos , Radiografia Intervencionista/instrumentação , Radiografia Intervencionista/métodos , Fluoroscopia/instrumentação , Fluoroscopia/métodos , Humanos , Cuidados Intraoperatórios/métodos , Valores de Referência , Estudos Retrospectivos , Reino Unido
4.
J Surg Res ; 257: 529-536, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32919343

RESUMO

BACKGROUND: Previous investigation has shown that the combined predictive value of white blood cell count and ultrasound (US) findings to be superior to either alone in children with suspected appendicitis. The purpose of this study was to evaluate the impact of a diagnostic clinical pathway (DCP) leveraging the combined predictive value of these tests on computed tomography (CT) utilization and resource utilization. METHODS: Retrospective cohort study comparing 8 mo of data before DCP implementation to 18 mo of data following implementation. The pathway incorporated decision-support for disposition (operative intervention, observation, or further cross-sectional imaging) based on the combined predictive value of laboratory and US data (stratifying patients into low, moderate, and high-risk groups). Study measures included CT and magnetic resonance imaging utilization, imaging-related cost, time to appendectomy, and negative appendectomy rate. RESULTS: Ninety-seven patients in the preintervention period were compared with 319 patients in the postintervention period. Following DCP implementation, CT utilization decreased by 86% (21% versus 3%, P < 0.001). Mean time to appendectomy decreased from 8.5 to 7.2 h (P < 0.001), and the negative appendectomy rate remained unchanged (5% versus 4%, P = 0.54). Magnetic resonance imaging utilization increased following pathway implementation (1% versus 7%, P = 0.02); however, median imaging-related cost was significantly lower in the postimplementation period ($283/case to $270/case, P = 0.002) CONCLUSIONS: In children with suspected appendicitis, implementation of a DCP leveraging the combined predictive value of white blood cell and US data was associated with a reduction in CT utilization, time to appendectomy, and imaging-related cost.


Assuntos
Apendicectomia/estatística & dados numéricos , Apendicite/diagnóstico por imagem , Procedimentos Clínicos/estatística & dados numéricos , Exposição à Radiação/prevenção & controle , Ultrassonografia , Adolescente , Apendicite/sangue , Apendicite/cirurgia , Criança , Feminino , Humanos , Contagem de Leucócitos , Imagem por Ressonância Magnética/estatística & dados numéricos , Masculino , Valor Preditivo dos Testes , Estudos Retrospectivos , Medição de Risco , Tempo para o Tratamento , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Procedimentos Desnecessários/economia , Procedimentos Desnecessários/estatística & dados numéricos , Adulto Jovem
5.
PLoS One ; 15(12): e0243367, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33378404

RESUMO

It has been almost 10 years since the accident at Tokyo Electric Power Co., Inc.'s Fukushima Daiichi Nuclear Power Plant in March 2011. This study elucidates changes in the mental states of mothers and children residing in low-dose radiation contaminated regions within Fukushima Prefecture over a five-year period after the Fukushima Daiichi accident. From 2011 to 2015, questionnaire surveys assessing psychological symptoms, including posttraumatic stress disorder-related responses, depressive responses, and stress responses, and radiation protection behaviors were conducted with 18,741 mothers of children aged four, 18, and 42 months. Mothers' and children's psychological symptoms and mothers' radiation protection behaviors were highest in 2011, immediately following the nuclear accident, but decreased over time. However, even in 2015, psychological symptoms and radiation protection behaviors were higher for children and mothers within Fukushima Prefecture than for those in a control group living in regions outside the area, which were minimally affected by the accident. The results suggest that the psychological effects in mothers and children living in low-dose radiation contaminated areas continued for at least five years after the accident. Furthermore, psychological effects in children born after the incident were likely to have been triggered by the parental behavior of mothers who were negatively affected by anxiety and stress. This finding raises concerns regarding the accident's long-lasting psychological effects in mothers and children living in low-contamination regions.


Assuntos
Ansiedade , Depressão , Acidente Nuclear de Fukushima , Saúde Mental , Exposição à Radiação/efeitos adversos , Transtornos de Estresse Pós-Traumáticos , Estresse Psicológico , Adulto , Ansiedade/epidemiologia , Ansiedade/psicologia , Criança , Pré-Escolar , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Lactente , Japão , Masculino , Pessoa de Meia-Idade , Mães/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia
6.
Environ Monit Assess ; 192(12): 782, 2020 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-33236230

RESUMO

The risk from naturally occurring radioactive materials (NORM) has been extensively assessed, and this has led to the integration of specific NORM radiation protection requirements within the latest EU Directive 2013/59. Nevertheless, it has been internationally recognised that remaining NORM knowledge gaps and uncertainties now present similarly significant issues in addressing recent regulatory requirements. The multi-tiered nature of environmental impact assessment (EIA) implies per se possibility for uncertainties, but when EIA at radiation exposure sites includes consideration of sites with multiple radiation and contamination sources, different ecosystem transport pathways, effects and risks by applying different parameters and models, level of overall uncertainty increases. The results of EIA study in the Fen area in Norway, comprised of undisturbed and legacy NORM sites, have been evaluated in this analysis, in order to identify all existing input uncertainties and how they may impact the final conclusions, and thus, influence any subsequent decision-making. The main uncertainties have been identified in the measurement and exposure analysis tier, and were related to the heterogeneous distribution of radionuclides, radionuclide speciation, as well as to generic variability issues in the concepts used for mobility and biota uptake analysis (such as distribution coefficient, transfer factors and concentration ratios) as well as radioecological modelling. The uncertainties in the input values to the calculation of the dose arising from radon exposure in the Fen area led to an overall elevated uncertainty of the magnitude of the radiation exposure dose of humans. It has been concluded that an integrated, ecosystem-based approach with consideration of complexity of prevailing environmental conditions and interconnections must be applied to fully understand possible radiation effects and risks.


Assuntos
Ecossistema , Exposição à Radiação , Exposição Ambiental , Monitoramento Ambiental , Humanos , Noruega , Incerteza
7.
Medicine (Baltimore) ; 99(45): e23105, 2020 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-33157985

RESUMO

The relationship between solar ultraviolet radiation and the risk of breast cancer is conflicting. The purpose of our study was to quantitatively assess the relationship between solar ultraviolet radiation and breast cancer risk and to analyze related factors such as age and sunscreen use.Articles indexed in PubMed and Embase and published between January 2005 and March 2020 were searched for relevant keywords. The relative risk was calculated using random-effect or fixed-effect models in the meta-analysis and dose-response meta-analysis, which were conducted according to the Meta-Analyses of Observational Studies in Epidemiology reporting guidelines. Sensitivity analyses for heterogeneity and publication bias were evaluated.Six studies were eligible for inclusion in the meta-analysis, and three of these were included in the dose-response analysis. We found a correlation between exposure to solar ultraviolet radiation and breast cancer risk (relative risk: 0.70, 95% confidence interval: 0.65, 0.75). We also found a linear dose-response relationship between the exposure and breast cancer risk (relative risk: 0.86, 95% confidence interval: 0.81, 0.91) in women over 40. Not tanning and covering the limbs were associated with breast cancer risk, but sunscreen use was not.Exposure to solar ultraviolet radiation is negatively correlated with breast cancer risk, and the association is linear in women over 40. This is the first dose-response meta-analysis on the topic, and the influence of factors such as estrogen receptor status, occupational exposure, and ethnicity requires in-depth study.


Assuntos
Neoplasias da Mama/epidemiologia , Neoplasias da Mama/etiologia , Neoplasias Induzidas por Radiação/epidemiologia , Neoplasias Induzidas por Radiação/etiologia , Exposição à Radiação/efeitos adversos , Luz Solar/efeitos adversos , Raios Ultravioleta/efeitos adversos , Relação Dose-Resposta à Radiação , Feminino , Humanos , Medição de Risco
8.
Br J Radiol ; 93(1115): 20200172, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-33021811

RESUMO

OBJECTIVE: Particle radiobiology has contributed new understanding of radiation safety and underlying mechanisms of action to radiation oncology for the treatment of cancer, and to planning of radiation protection for space travel. This manuscript will highlight the significance of precise physical and biologically effective dosimetry to this translational research for the benefit of human health.This review provides a brief snapshot of the evolving scientific basis for, and the complex current global status, and remaining challenges of hadron therapy for the treatment of cancer. The need for particle radiobiology for risk planning in return missions to the Moon, and exploratory deep-space missions to Mars and beyond are also discussed. METHODS: Key lessons learned are summarized from an impressive collective literature published by an international cadre of multidisciplinary experts in particle physics, radiation chemistry, medical physics of imaging and treatment planning, molecular, cellular, tissue radiobiology, biology of microgravity and other stressors, theoretical modeling of biophysical data, and clinical results with accelerator-produced particle beams. RESULTS: Research pioneers, many of whom were Nobel laureates, led the world in the discovery of ionizing radiations originating from the Earth and the Cosmos. Six radiation pioneers led the way to hadron therapy and the study of charged particles encountered in outer space travel. Worldwide about 250,000 patients have been treated for cancer, or other lesions such as arteriovenous malformations in the brain between 1954 and 2019 with charged particle radiotherapy, also known as hadron therapy. The majority of these patients (213,000) were treated with proton beams, but approximately 32,000 were treated with carbon ion radiotherapy. There are 3500 patients who have been treated with helium, pions, neon or other ions. There are currently 82 facilities operating to provide ion beam clinical treatments. Of these, only 13 facilities located in Asia and Europe are providing carbon ion beams for preclinical, clinical, and space research. There are also numerous particle physics accelerators worldwide capable of producing ion beams for research, but not currently focused on treating patients with ion beam therapy but are potentially available for preclinical and space research. Approximately, more than 550 individuals have traveled into Lower Earth Orbit (LEO) and beyond and returned to Earth. CONCLUSION: Charged particle therapy with controlled beams of protons and carbon ions have significantly impacted targeted cancer therapy, eradicated tumors while sparing normal tissue toxicities, and reduced human suffering. These modalities still require further optimization and technical refinements to reduce cost but should be made available to everyone in need worldwide. The exploration of our Universe in space travel poses the potential risk of exposure to uncontrolled charged particles. However, approaches to shield and provide countermeasures to these potential radiation hazards in LEO have allowed an amazing number of discoveries currently without significant life-threatening medical consequences. More basic research with components of the Galactic Cosmic Radiation field are still required to assure safety involving space radiations and combined stressors with microgravity for exploratory deep space travel. ADVANCES IN KNOWLEDGE: The collective knowledge garnered from the wealth of available published evidence obtained prior to particle radiation therapy, or to space flight, and the additional data gleaned from implementing both endeavors has provided many opportunities for heavy ions to promote human health.


Assuntos
Radioterapia com Íons Pesados , Neoplasias/radioterapia , Institutos de Câncer/provisão & distribução , Feminino , Radioterapia com Íons Pesados/história , Radioterapia com Íons Pesados/métodos , Radioterapia com Íons Pesados/estatística & dados numéricos , Íons Pesados/história , História do Século XIX , História do Século XX , Humanos , Malformações Arteriovenosas Intracranianas/história , Malformações Arteriovenosas Intracranianas/radioterapia , Íons/história , Masculino , Neônio/história , Neônio/uso terapêutico , Neoplasias Induzidas por Radiação/prevenção & controle , Nêutrons/história , Nêutrons/uso terapêutico , Prêmio Nobel , Aceleradores de Partículas , Prótons/história , Exposição à Radiação , Proteção Radiológica , Radiobiologia/história , Voo Espacial
9.
PLoS One ; 15(10): e0233941, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33108378

RESUMO

We aimed to estimate the rate of germline mutations in the offspring of individuals accidentally exposed to Cesium-137 ionizing radiation. The study included two distinct groups: one of cases, consisting of males and females accidentally exposed to low doses of ionizing radiation of Cs137, and a control group of non-exposed participants. The cases included 37 people representing 11 families and 15 children conceived after the accident. Exposed families incurred radiation absorbed doses in the range of 0.2 to 0.5 Gray. The control group included 15 families and 15 children also conceived after 1987 in Goiânia with no history of radiation exposure. DNA samples from peripheral blood were analyzed with the Affymetrix GeneChip® CytoScanHD™ to estimate point mutations in autosomal SNPs. A set of scripts previously developed was used to detect de novo mutations by comparing parent and offspring genotypes at the level of each SNP marker. Overall numbers of observed Mendelian deviations were statistically significant between the exposed and control groups. Our retrospective transgenerational DNA analysis showed a 44.0% increase in the burden of SNP mutations in the offspring of cases when compared to controls, based on the average of MFMD for the two groups. Parent-of-origin and type of nucleotide substitution were also inferred. This proved useful in a retrospective estimation of the rate of de novo germline mutations in a human population accidentally exposed to low doses of radiation from Cesium-137. Our results suggested that observed burden of germline mutations identified in offspring was a potentially useful biomarker of effect to estimate parental exposure to low doses of IR and could become an important marker suitable for biomonitoring human population exposed to environmental mutagens.


Assuntos
Radioisótopos de Césio/efeitos adversos , Técnicas de Genotipagem/métodos , Mutação em Linhagem Germinativa , Polimorfismo de Nucleotídeo Único , Exposição à Radiação/efeitos adversos , Adolescente , Adulto , Substituição de Aminoácidos , Estudos de Casos e Controles , Criança , Pré-Escolar , Desastres , Feminino , Humanos , Lactente , Masculino , Análise da Randomização Mendeliana , Pessoa de Meia-Idade , Linhagem , Radiação Ionizante , Liberação Nociva de Radioativos , Estudos Retrospectivos , Adulto Jovem
10.
Artigo em Chinês | MEDLINE | ID: mdl-33036530

RESUMO

Objective: To understand the personal dose level of nuclear medical workers in a hospital, and to provide basis for health management of nuclear medicine occupational population. Methods: From January 2014 to December 2018, 147 radiation workers in a hospital were selected as the monitoring objects, and the individual dose monitoring data were analyzed. The correlation between individual dose and clinical workload was analyzed. Results: The average annual personal dose of 147 staff members was below the national dose limit. Compared with the radiation department, the average annual personal dose of nuclear medical staff was higher, and the difference was statistically significant (P<0.05) . There was a positive correlation between the annual average personal dose and the corresponding injection workload (Rs=0.69, P<0.05) . Conclusion: The occupational exposure risk of nuclear medical technicians and nurses is high, and reasonable protective measures should be taken to reduce the radiation exposure dose. Conclusion The occupational exposure risk of nuclear medical technicians and nurses is high, and reasonable protective measures should be taken to reduce the radiation exposure dose.


Assuntos
Medicina Nuclear , Exposição Ocupacional , Exposição à Radiação , Monitoramento de Radiação , Humanos , Exposição Ocupacional/análise , Doses de Radiação
12.
Mutat Res ; 856-857: 503234, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32928374

RESUMO

We report two cases of interventional radiologists who had been exposed to radiation while performing fluoroscopically-guided interventional procedures (FGIPs), mainly transcatheter arterial chemoembolization, percutaneous catheter drainage, and percutaneous transhepatic biliary drainage procedures, for over 10 years. They had a unique multi-aberrant cell type with not only high numbers of dicentrics and/or centric rings but also excess acentric double minutes, similar to a rogue cell. As revealed in a self-administered questionnaire, they wore personal dosimeters and protective equipment at all times and used shielding devices during interventional fluoroscopy procedures. However, the exposed dose levels derived from cytogenetic dosimetry were much higher than the doses recorded on their personal dosimeters. A large number of unstable and stable chromosomal aberrations that were found in the peripheral blood lymphocytes of these interventional radiologists might be due to repeated and long-term exposure to ionizing radiation while performing FGIPs. Further investigations of chromosomal aberrations in interventional radiologists may improve the understanding of the long-term effects of radiation exposure on medical personnel.


Assuntos
Fluoroscopia/efeitos adversos , Linfócitos/efeitos da radiação , Exposição Ocupacional/efeitos adversos , Radiologia Intervencionista/normas , Adulto , Quimioembolização Terapêutica/efeitos adversos , Aberrações Cromossômicas/efeitos da radiação , Feminino , Humanos , Linfócitos/patologia , Masculino , Pessoa de Meia-Idade , Doses de Radiação , Exposição à Radiação/efeitos adversos , Radiação Ionizante , Radiometria/efeitos adversos
14.
Artigo em Chinês | MEDLINE | ID: mdl-32892583

RESUMO

Objective: To investigate the situation of wearing protective equipment in the process of X-ray radiation examination (including DR and CT) in a 3A general hospital, so as to provide technical basis and solutions for better reducing the radiation dose of accompanying patients. Methods: From November 1, 2018 to June 30, 2019, the accompanying examinee 6 who had to stay in the examination room during the radiology examination (X-ray and CT examination) of a 3A general hospital from June 1, 2018 to June 30, 2019 was selected 535 people were divided into three groups according to whether they were reminded and instructed to wear protective equipment: group A was not reminded (group A) , group B was reminded to wear protective equipment, and group C was reminded and instructed to wear protective equipment (Group C) . Results: The wearing rates of protective equipment of the three groups were 35.0% (744/2126) , 85.2% (1858/2181) and 91.0% (2028/228) , and the complete wearing rates were 15.0% (319/2126) , 54.8% (1195/2181) and 88.0% (1960/228) , respectively. 4% (1450/3060) , 28.6% (876/3060) , 24.0% (734/3060) , respectively. 523 patients refused to wear protective equipment. The main reasons were emotion (33.8%, 177/523) and time (32.5%, 170/523) . Conclusion: The intervention of radiation workers can effectively improve the correct wearing rate of protective equipment and reduce the radiation exposure of accompanying people.


Assuntos
Equipamentos de Proteção , Exposição à Radiação , Proteção Radiológica , Humanos , Radiografia , Raios X
15.
Artigo em Chinês | MEDLINE | ID: mdl-32892599

RESUMO

Objective: To investigate the effects of long-term ionizing radiation on peripheral blood cells of nuclear power workers. Methods: In March 2019, a total of 530 radiation exposed workers in the nuclear power industry who underwent in-service radiation occupational health examination in Guangzhou occupational disease prevention and control hospital in 2018 and with service age ≥1 year were selected as the radiation group. At the same time, 545 workers in nuclear power industry were selected as control group. According to the methods and requirements of GBZ 235-2011 "technical specification for occupational health monitoring of radiation workers" and GBZ 98-2017 "health requirements for radiation workers", the occupational health monitoring data were collected, and the change rules of peripheral blood cells in the two groups were analyzed. Results: Compared with the control group, the total number of WBC, NEUT, LYMP, Hb, MCV and MCHC in radiation group were lower than those in control group (P<0.05) , and the difference was statistically significant (P<0.05) . The MPV increased significantly (P<0.05) . Compared with the control group, the abnormal rate of WBC and Hb in the radiation group was higher than that in the control group (P<0.01) , but there was no significant difference in the abnormal rate of RBC and PLT (P>0.05) . Conclusion: Low dose ionizing radiation has a certain cumulative damage effect on peripheral blood cells of radiation workers in nuclear power industry. The change rules of different cell subtypes are different, and the changes of WBC and PLT appear earlier.


Assuntos
Doenças Profissionais , Exposição Ocupacional , Exposição à Radiação , Células Sanguíneas , Humanos , Indústrias , Radiação Ionizante
16.
PLoS One ; 15(9): e0238127, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32960898

RESUMO

PURPOSE: The aim of this study was to assess the determinants of bone health in the group of women over 40 years old. Lifestyle factors such as past and present physical activity, past and present sun exposure, current dietary intake of calcium and vitamin D, nutritional status as measured by BMI, family history of osteoporosis and current hormonal status were analysed. METHODS: The study involved 500 women over 40 years old. All examined women was the same ethnicity- European origin. Methods used: densitometry method (DXA), bioelectrical impedance analysis, International Physical Activity Questionnaire, nutrition questionnaire, past and present sun exposure questionnaire. Past and present physical activity, past and present sun exposure and sufficient level of calcium in the diet proved to be the most important factors determining mineralization of bone tissue of women. In order to indicate an independent association of the correct bone tissue mineralization with individual factors, multivariate analysis was used-logistic regression. RESULTS: The norm BMD in the distal part of the forearm was strongly influenced: recommended dietary calcium intake (OR = 5.95; p = 0.003), moderately (OR = 1.88; p = 0.053) and high (OR = 14.0; p<0.001) past physical activity, sufficient (OR = 4.97; p<0.001) and high (OR = 18.9; p = 0.004) level of present physical activity, sufficient past (OR = 5.15; p<0.001) and sufficient present sun exposure (OR = 10.0; p<0.001). The chance for the BMD prox norm was also increased several times: high past physical activity (OR = 68.4; p<0.0001) and sufficient past sun exposure (OR = 10.6; p<0.001), moderate past activity (OR = 4.20; p<0.001), sufficient (OR = 6.13; p<0.001) and high (OR = 10.0; p<0.001) present physical activity, sufficient present sun exposure (OR = 9.09; p<0.0001), recommended intake of calcium (OR = 9.57; p<0.001) and vitamin D (OR = 2.68; p = 0.052). Whereas e significantly lower likelihood for the BMD prox norm was found in women with the oldest hormonal status (postmenopausal period) (OR = 0.18; p<0.001), with osteoporosis in the family (OR = 0.37; p<0.001) and living in an agglomeration (OR = 0.68; p = 0.03). CONCLUSION: Interventions to increase physical activity, especially outdoors, may help reduce risk of osteoporosis, fractures and subsequent healthcare costs.


Assuntos
Densidade Óssea/fisiologia , Densidade Óssea/efeitos da radiação , Exercício Físico , Estado Nutricional , Exposição à Radiação/análise , Luz Solar , Índice de Massa Corporal , Densidade Óssea/efeitos dos fármacos , Cálcio/farmacologia , Suplementos Nutricionais , Feminino , Humanos , Estilo de Vida , Modelos Logísticos , Anamnese , Pessoa de Meia-Idade , Polônia , Vitamina D/farmacologia
17.
Br J Radiol ; 93(1115): 20200245, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-32970457

RESUMO

Not surprisingly, our knowledge of the impact of radiation on the brain has evolved considerably. Decades of work have struggled with identifying the critical cellular targets in the brain, the latency of functional change and understanding how irradiation alters the balance between excitatory and inhibitory circuits. Radiation-induced cell kill following clinical fractionation paradigms pointed to both stromal and parenchymal targets but also defined an exquisite sensitivity of neurogenic populations of newly born cells in the brain. It became more and more apparent too, that acute (days) events transpiring after exposure were poorly prognostic of the late (months-years) waves of radiation injury believed to underlie neurocognitive deficits. Much of these gaps in knowledge persisted as NASA became interested in how exposure to much different radiation types, doses and dose rates that characterize the space radiation environment might impair central nervous system functionality, with possibly negative implications for deep space travel. Now emerging evidence from researchers engaged in clinical, translational and environmental radiation sciences have begun to fill these gaps and have uncovered some surprising similarities in the response of the brain to seemingly disparate exposure scenarios. This article highlights many of the commonalities between the vastly different irradiation paradigms that distinguish clinical treatments from occupational exposures in deep space.


Assuntos
Neoplasias Encefálicas/radioterapia , Encéfalo/efeitos da radiação , Exposição à Radiação/efeitos adversos , Lesões por Radiação/complicações , Voo Espacial , Neoplasias Encefálicas/terapia , Transtornos Cognitivos/etiologia , Humanos , Íons , Transferência Linear de Energia , Doses de Radiação , Exposição à Radiação/prevenção & controle , Lesões por Radiação/prevenção & controle
18.
Radiol Med ; 125(11): 1024-1039, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32930945

RESUMO

Computed tomography coronary angiography (CTCA) has become a cornerstone in the diagnostic process of the heart disease. Although the cardiac imaging with interventional procedures is responsible for approximately 40% of the cumulative effective dose in medical imaging, a relevant radiation dose reduction over the last decade was obtained, with the beginning of the sub-mSv era in CTCA. The main technical basis to obtain a radiation dose reduction in CTCA is the use of a low tube voltage, the adoption of a prospective electrocardiogram-triggering spiral protocol and the application of the tube current modulation with the iterative reconstruction technique. Nevertheless, CTCA examinations are characterized by a wide range of radiation doses between different radiology departments. Moreover, the dose exposure in CTCA is extremely important because the benefit-risk calculus in comparison with other modalities also depends on it. Finally, because anatomical evaluation not adequately predicts the hemodynamic relevance of coronary stenosis, a low radiation dose in routine CTCA would allow the greatest use of the myocardial CT perfusion, fractional flow reserve-CT, dual-energy CT and artificial intelligence, to shift focus from morphological assessment to a comprehensive morphological and functional evaluation of the stenosis. Therefore, the aim of this work is to summarize the correct use of the technical basis in order that CTCA becomes an established examination for assessment of the coronary artery disease with low radiation dose.


Assuntos
Angiografia por Tomografia Computadorizada/métodos , Angiografia Coronária/métodos , Doença da Artéria Coronariana/diagnóstico por imagem , Doses de Radiação , Exposição à Radiação/prevenção & controle , Fatores Etários , Algoritmos , Inteligência Artificial , Índice de Massa Corporal , Angiografia por Tomografia Computadorizada/instrumentação , Circulação Coronária , Feminino , Reserva Fracionada de Fluxo Miocárdico , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco , Fatores Sexuais , Fatores de Tempo
19.
Mutat Res ; 856-857: 503237, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32928370

RESUMO

Radiation has widespread applications in medicine. However, despite the benefits of medical radiation exposures, adverse long-term health effects are cause for concern. Protein and gene biomarkers are early indicators of cellular response after low-dose exposure. We examined DNA damage by quantifying γ-H2AX foci and expression of twelve candidate genes in the blood lymphocytes of patients exposed to low doses of X-radiation during neuro-interventional procedures. Entrance surface dose (ESD; 10.92-1062.55 mGy) was measured by thermoluminescence dosimetry (TLD). Absorbed dose was estimated using γ-H2AX focus frequency and gene expression, with in vitro dose-response curves generated for the same biomarkers. γ-H2AX foci in post-exposure samples were significantly higher than in pre-exposure samples. Among the genes analysed, FDXR, ATM, BCL2, MDM2, TNFSF9, and PCNA showed increased expression; CDKN1A, DDB2, SESN1, BAX, and TNFRSF10B showed unchanged or decreased expression. Absorbed dose, estimated based on γ-H2AX focus frequency and gene expression changes, did not show any correlation with measured ESD. Patients undergoing interventional procedures receive considerable radiation doses, resulting in DNA damage and altered gene expression. Medical procedures should be carried out using the lowest radiation doses possible without compromising treatment.


Assuntos
Histonas/efeitos da radiação , Linfócitos/efeitos da radiação , Imagem por Ressonância Magnética Intervencionista/efeitos adversos , Exposição à Radiação/efeitos adversos , Dano ao DNA/efeitos da radiação , Relação Dose-Resposta à Radiação , Feminino , Regulação da Expressão Gênica/efeitos da radiação , Histonas/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes , Doses de Radiação , Raios X/efeitos adversos
20.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32994178

RESUMO

BACKGROUND AND OBJECTIVES: Postpyloric feeding tube placement is a time-consuming procedure associated with multiple attempts and radiation exposure. Our objective with this study is to compare the time, attempts, and radiation exposure using the electromagnetic versus blind method to place a postpyloric feeding tube in critically ill children. Our hypothesis is that using electromagnetic guidance decreases the procedure time, number of x-rays, and number of attempts, compared to the blind method. METHODS: Eleven pediatric nurses participated in a randomized controlled intention-to-treat study at an academic pediatric medical, surgical, and congenital cardiac ICU. University of Texas Health Epidemiology and Biostatistics generated a randomization sequence with sealed envelopes. A standard (2-sided) F-test of association between the electromagnetic and blind method yielded 40 subjects with 86% power. Data were analyzed with Fisher's exact test for categorical variables and the Wilcoxon rank test for continuous variables, with data documented as median (interquartile range [IQR]). RESULTS: We randomly assigned 52 patients to either the electromagnetic (n = 28) or blind method (n = 24). The number of attempts and radiographs was at a median of 2 (IQR: 1-2.25) using the blind method, compared to the electromagnetic method at a median of 1 (IQR: 1.0-1.0; P = .001). Successful guidance was 96.4% with the electromagnetic method, compared to only 66.7% with the blind technique (P = .008). The total time required was 2.5 minutes (IQR: 2.0-7.25) with the electromagnetic method, compared to 19 minutes (IQR: 9.25-27.0) for the blind method (P = .001). CONCLUSIONS: Electromagnetic guidance is a superior, faster, and overall safer method to place a postpyloric feeding tube in critically ill children.


Assuntos
Intubação Gastrointestinal/métodos , Imãs , Piloro , Adolescente , Adulto , Criança , Pré-Escolar , Estado Terminal , Campos Eletromagnéticos , Nutrição Enteral/métodos , Feminino , Humanos , Análise de Intenção de Tratamento , Intubação Gastrointestinal/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Piloro/diagnóstico por imagem , Exposição à Radiação/prevenção & controle , Radiografia Abdominal/estatística & dados numéricos , Estatísticas não Paramétricas , Fatores de Tempo , Adulto Jovem
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